Rise in organ donations raises ethical issues

OTTAWA -- Increasing numbers of people killed by euthanasia are supplying a “boon” for organ transplant surgeries in Canada, according to an Ottawa newspaper. But politicians and ethicists say the practice is “rather horrifying” and raises questions of “coercion.”

A Jan. 6 article in the Ottawa Citizen, titled “Medically assisted deaths prove a growing boon to organ donation in Ontario,” explained that while the number of people in need of a transplant in Ontario has remained relatively static, fewer and fewer people are registering in advance as donors, with assisted deaths providing a positive answer. 

“This relatively new source of organs and tissues is significant in that Ontario’s waiting list for organs typically hovers around 1,600 without any great headway made to eliminate that number,” the paper reported.

From January until November of 2019, there were 18 organ and 95 tissue donations from patients who died by euthanasia. These numbers, which do not include the month of December, represent an increase of 14 per cent over all of 2018, and 109 per cent compared to all of 2017. 

According to the Trillium Gift of Life Network, which runs organ and tissue donation in Ontario, these donations were five per cent of the province’s overall number of organ and tissue donations. This was more than double the percentage of euthanasia-related donations in 2017. 

Assisted suicide, or Medical Assistance in Dying (MAiD) as it is legally referred to, has been legal in Canada since 2016.

In Ontario, Trillium “proactively” solicits patients to discuss organ donation once they have elected to be killed.

Ronnie Gavsie, the CEO of Trillium, defended this as “the right thing to do for those on the (organ donation) wait list.” 

In Quebec, it recently was approved for Transplant Quebec to raise the possibility of organ donation after a request to die by euthanasia is approved by doctors. 

Conservative MP Michael Cooper told CNA that while he is not necessarily opposed to someone donating their organs after dying by euthanasia, he said the practice raises questions regarding consent and opens up the possibility of coercion. 

“The concern that I have is that it muddies the waters in terms of the patient making a decision freely, without any degree of coercion or influence from anyone,” said Cooper.

Dr. Moira McQueen, executive director of the Canadian Catholic Bioethics Institute, said such practices appear “rather horrifying.” She cited the scenario of a patient who opts to begin the euthanasia process at home and be transferred to a hospital for organ donation as one that sparks “even more ethical and legal problems.” In this case, a patient would essentially be sedated at home and then transported to a hospital for the final dose of lethal medication and then have their organs removed. 

“That situation makes it clearer that the focus is truly on ‘harvesting,’ ” said McQueen. “The donor’s dignity is compromised and the ‘separation’ of teams that is supposed to be the warrant of independence of the teams is completely blurred.” 

While the Church does not have ethical issues with the use of organ donations from consenting donors who died natural deaths, McQueen said there are serious ethical questions about the transplant use of organs retrieved after euthanasia. 

“There’s no Church teaching on it that says specifically, you can’t. There is definitely something that talks about the dignity of the body, and I would think, as a Catholic, most of us would say ‘oh no, you can’t use these organs because the person has died a sinful death, died a wrong death by asking for euthanasia,’ ” she said.